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Depression during pregnancy has been correlated to premature delivery, low birth weight, and increased morbidity and mortality in newborns. Studies have shown that massage therapy helps to decrease depression in pregnancy. In addition, there is speculation that yoga may decrease premature delivery and increase birth weight. Long-time researchers in the field of massage therapy from the Touch Research Institute at the University of Miami School of Medicine in Florida assessed the effectiveness of yoga, massage therapy, and standard care only to alleviate depression in pregnant women and prevent premature delivery.

Researchers screened 208 women between 18 and 22 weeks gestation for depression using the Center for Epidemiological Studies Depression Scale. The participants were screened at their first scheduled ultrasonography (mean, 20 weeks gestation). Women older than 18 years, having an uncomplicated singleton pregnancy, and receiving a diagnosis of depression through the use of the Structured Clinical Interview for Depression met inclusion criteria. Women with diabetes, with HIV, aged greater than 40 years, who were self-reported drug users (or who used medication that might increase depressive effects), or diagnosed with other psychiatric conditions such as bipolar disorder were excluded. Eighty-four participants qualified and completed the study.

Five additional questionnaires were administered to participants to examine sociodemographics: comorbid psychological conditions; anxiety, a common comorbidity with depression; and anger, another common comorbidity with depression that has been noted to negatively impact neonatal outcome. Additional outcome measures included birth weight, gestational age, back pain, and leg pain.

Each participant received identical prenatal care and was randomly assigned to receive yoga, massage therapy, or standard prenatal care (control). Those assigned to yoga received 12 weekly sessions of professional yoga instruction (20 minutes per session) geared toward women in their second and third trimester. The massage group received 10 minutes of massage therapy lying on each side (20 minutes total) from a licensed massage therapist for 12 weeks. The researchers assessed the participants at the start of their regimen at 20 weeks gestation and again after the 12 weeks of treatment at 32 weeks gestation.

Demographic variables such as average age (26 years) and socioeconomic status (low) did not differ between the 3 groups. Both the yoga and massage groups showed significant improvement in depression (F=82.40, P<.001), anxiety (F=26.23, P<.001), anger (F=14.59, P<.001), back pain (F=39.06, P<.001), leg pain (F=19.77, P>.001), and relationships (F=7.88, P<.001) compared with the standard care group. Additionally, the interventional groups (yoga and massage) yielded a significantly increased gestational age (F=18.83, P<.005) and birth weight (F=31.52, P<.001) compared with those of the standard care group.

Both yoga and massage therapy in addition to standard care appear to be valuable complementary treatments for patients with depression during pregnancy. Limitations of the study include the lack of a placebo or sham therapy group and not assessing the combined effects of massage therapy plus yoga in addition to standard care.

“The Somatic Connection” highlights and summarizes important contributions to the growing body of literature on the musculoskeletal system's role in health and disease. This section of The Journal of the American Osteopathic Association (JAOA) strives to chronicle the significant increase in published research on manipulative methods and treatments in the United States and the renewed interest in manual medicine internationally, especially in Europe.